A damaged heart valve meant Ruth had to make a tough decision

Ruth is a management accountant in Perth. With partner Brian, she loves travelling when she can. They’ve been to so many places, she finds it tough to pick a favourite, but if she was given a ticket to go back to a place, she’d choose South America. “The people, their history, the scenery is so different from Europe, the Americas and Asia.”

Ruth's heart story

I’d always been healthy and fairly active, but in 2017 I started to get palpitations. They ranged in severity, but when they got really bad, it felt like my heart was jumping out of my body. Sometimes, they made me feel faint and tight in my chest. They might last five minutes, or they might last an hour.

I’d probably had them for about 18 months before I became quite concerned. I thought they might have been linked to menopause - I was about 54 when they started - but because they were sporadic, I just struggled through.  

My partner Brian and I love travelling. We haven’t been everywhere, but we’ve given it a good go over the last 17 years: Sri Lanka, USA, Canada, Europe, South America, NZ, Sabah-Borneo, Singapore and Hong Kong. In 2018 we went on a big adventure, starting in Portugal for Eurovision, then off to Spain, France, across the channel to Guernsey, Jersey then into Portsmouth to start our four-month trip around UK and Ireland. 

It was a wonderful trip, but I started to feel breathless walking up hills or after climbing stairs to the top of church spires and I knew it was time to do something. I’d always struggled a little on our trips, climbing or doing long walks, long before the palpitations started. 

My GP did some basic tests and sent me off to see a cardiologist saying, ‘You might have AF’. I had no idea what that was, but I soon found out that atrial fibrillation is a type of irregular heartbeat. 

In fact, I was diagnosed with a severe mitral valve prolapse. It meant that the valve between the chambers on the left side of my heart wasn’t closing properly, and that blood was leaking into my left ventricle. That’s what was causing problems with my heart’s rhythm, as well as making me tired and breathless.

The diagnosis completely knocked me for six! The specialist couldn’t tell me for sure how long it had been like that, but it might have been since I was very young. Looking back, it made sense. I was into sports, but I wasn’t that into sports. I tired easily and assumed I was just never fit enough to compete. My surgeon explained that while it might be possible to repair the malfunctioning mitral valve, he couldn’t know for sure until the surgery started. Only then could he really assess the state of the valve. 

But what that meant was that I had a really big decision to make before the surgery. If my mitral valve was beyond repair and needed to be replaced, what sort of replacement valve did I want? 

I learnt that there were two possibilities. One was a valve made from animal tissue – it could be cow, pig or even human heart tissue. The benefit of this choice was that it wouldn’t be necessary to take a blood thinner like Warfarin every day for the rest of my life. But a tissue valve has a limited lifespan and after a certain number of years - maybe 10 to 15, depending on the individual - I might need more surgery to replace it.

The second option was a man-made mechanical valve. It would last much longer than a tissue valve - with any luck, the rest of my life - but there was a slightly higher risk of infection and, of course, I’d need to take Warfarin every day to help prevent blood clots. 
It seemed a huge decision, and it was all on me. Do I turn left or right?
It seemed hard to find the information I needed, but I did my research and decided on a mechanical valve. I felt scared in the days and weeks before my surgery. I was like a duck – calm on top but I was kicking like anything below the water. In my mind, I’d pretty much ruled out the likelihood that the surgeon could repair the valve. If he did, I’d wake to a wonderful surprise! But by now I’d come to terms with having a mechanical valve.

I really don’t want to revisit the night before – it was absolutely awful. I was so scared and felt quite alone once Brian left me. When I woke up from surgery, I found out that the mitral valve couldn’t be repaired and that I had a mechanical valve opening and closing in my chest. I had also had catheter ablation, a procedure to fix my atrial fibrillation. At the time, I was just glad to wake up! The surgeon was wonderful and gave me lots of information and support.  

People ask how it feels to have a man-made valve. To be honest, I haven’t felt that different. Sometimes I am aware of it as I drift off to sleep, and my partner says he can sometimes hear it.  

After the surgery, the hospital and my cardiologist said it would be wise to do some cardiac rehab exercise and my GP provided the referral. I joined a gym specialising in cardiac rehab and was going twice a week up to for sessions based on my own personal needs. I found it very helpful, it made me exercise as I had to be there. I saw other people of all ages going through their own medical issues, I think I was one of the youngest there. It’s helping me not just physically but mentally to know that I can have a good life ahead and to know that I need to look after myself and to exercise and not be scared of it.

The COVID-19 crisis meant my gym sessions were suspended so I had to do them at home. I’m lucky I can do most of the workout with the equipment I already have.  

I am still recovering really, and time will tell the effect the mitral valve replacement will have on me. But travelling is in our blood and we always have plans. Perhaps next time I climb a church spire, I won’t be breathless and all I’ll need to do at the top is admire the view.  

Ruth’s advice  

I created my own little Ruth’s Heart Book which had everything from doctors’ contacts, questions for my cardiologist and surgeon and websites to visit, to comments from people I had contacted or items of interest to locate and read. I also used my book for when I was in the hospital to capture my thoughts and anything I needed to remember for later: your mind is all over the place with so much going on.

I think my time spent researching, asking questions and contacting various organisations helped me to make my decision on the mechanical valve and gave me confidence.


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